Dexmedetomidine

Question 1

Dexmedetomidine Class

Answer 1

Selective alpha2 adrenergic agonist

Question 2

Dexmedetomidine Uses (5)

Answer 2

Monitored anesthesia care

Induction

Analgesia

Prevention of emergence delirium (esp in peds)

Reduces inhalation agent requirements

Question 3

Dexmedetomidine MOA

Answer 3

Centrally and peripherally alpha 2 adrenergic receptor agonist.

Question 4

Dexmedetomidine Dosing

Answer 4

For procedural sedation: start at 1 mcg/kg over 10 minutes, followed by a maintenance infusion from 0.2 to 1 mcg/kg/hr.

Question 5

Dexmedetomidine CV Effects (2)

Answer 5

Hypotension

Bradycardia

Question 6

Dexmedetomidine Respiratory Effects (1)

Answer 6

Minimal respiratory depression

Question 7

Dexmedetomidine CNS Effects (3)

Answer 7

Sedation

Analgesic properties

Enhance neuraxial blockade

Question 8

Dexmedetomidine Metabolism

Answer 8

Metabolized by the P450 system in the liver

Question 9

Dexmedetomidine Excretion

Answer 9

Cleared by the liver

Inactive metabolites

Question 10

Dexmedetomidine Effects on CV System and Autonomic Nervous System (3)

Answer 10

Regulates the cardiovascular system by inhibiting norepinephrine release.

Reduces blood pressure and heart rate by decreasing the tonic levels of sympathetic outflow from the CNS and augmenting cardiac vagal activity.

Produces sedation by decreasing sympathetic nervous system activity and the level of arousal.